HIP OSTEOARTHRITIS

WHAT IS OSTEOARTHRITIS?

 A lot of different conditions and predisposing factors may contribute to osteoarthritis of the hip but the exact reason is often not obvious. In the most common form it is put down to long term wear and tear to the cartilage that naturally cushions the hip joint. This causes the bones in the joint to rub together and cause inflammation and pain. Over time the lining of the joint thickens, bony spurs grow at the edges and cysts develop under the joint surface.

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WHAT ARE THE RISK FACTORS?

• Genetics. You are more likely to develop osteoarthritis if you have family members suffering from it.

• Age. The older you are the more likely that you will develop the disease, but it is far from inevitable.

• Sex. Under the age of 50 men are more likely to be affected. Over 50 women are more at risk.

• You are more likely to develop osteoarthritis if you are overweight or obese. You can check your BMI here.

• Occupation. Heavy manual work and repeated high impact activities may lead to osteoarthritis in later life.

• Previous injury to the hip.

• Developmental dysplasia. When the hip does not form normally and the ball and socket do not match the cartilage is more likely to wear out.

• Diseases like rheumatoid arthritis and other systemic inflammatory conditions may lead to similar destruction of the hip joint.

• Pain. Most people localise the pain in the groin and thigh, but you may feel it on the side of the hip and in the buttock or even in the knee. At the onset of the disease you may only feel it after a longer walk or strenuous activity, but later it can become constant including at night.

• Stiffness. The first movement to go is rotating the hip inwards then all other movements decrease gradually. This leads to difficulty putting on socks and shoes and getting in and out of the car.

• You may feel or even hear creaking or grinding from the joint in advanced bone-on-bone arthritis.

• Limited mobility. The usual walks become shorter and shorter and in the end you may only be able to walk a few hundred yards with significant limp.

HOW IS OSTEOARTHRITIS DIAGNOSED?

• A history of the typical symptoms is usually enough to make the diagnosis.

• The clinical examination confirms the painfully limited movement of the hip joint. Examination of the other hip, the spine, knee, walking pattern and leg length gives further information for the planning of your treatment.

• An x-ray is necessary if surgical treatment is considered and also to exclude other conditions.

• An MRI scan is not necessary to confirm you have osteoarthritis, but it can be useful to diagnose avascular necrosis, stress fracture, hip impingement or soft tissue problems around the hip.

Depending on the severity of your symptoms you may be able to manage it conservatively (without an operation) or may need a hip replacement.

Conservative treatment consists of a combination of lifestyle changes, exercise and taking medication such as pain killers and anti-inflammatories.

A hip injection can be considered in mild to moderate arthritis when there is still some cartilage left in the joint.